'No place in Scotland' for restraint in care following Care Review

The review team listened to evidence from more than 5500 people, over half of whom were care-experienced children and young adults, those who have lived in care, and their families.

Their experiences include the use of restraint, which has been used on children as young as eight-years-old in many residential care settings including children’s homes and secure accommodation.

There is no agreed Scotland-wide definition of restraint, which ranges from putting pressure on a young person’s shoulder to stop them from doing something that would hurt themselves or others, to pulling them to the ground in a rugby-style tackle.

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The Scottish Government’s Holding Safely guidance, published in 2005 and updated in 2013, says it should be used as a last resort but recognises it sometimes becomes assault. Numerous reports, some dating back decades, have highlighted concerns.

Resulting injuries have been documented from carpet burns to broken bones as well as psychological trauma such as flashbacks to child abuse. Young people have previously told the Sunday National about agreed restraint “safe holds” that saw them pinned to the ground by up to four adults. In one harrowing case, which saw the worker deemed no longer fit to practice, a young man in a children’s home was put in a headlock, his hand grabbed and repeatedly used to punch himself in the face.

The Care Review said that children and young people had told researchers that they found its use “frightening, painful and embarrassing” especially when it was used in times of distress.

They also claimed it was sometimes not used to keep children safe, but as a punishment for perceived wrongdoing. Heartbreakingly, the review also heard from children who sought out restraint as it was the only time they experienced human touch.

The review concluded: “Restraint does not work for anyone. Pain compliance techniques have no place in a Scotland that aims to ensure its children feel loved.”

Fiona Duncan, the chair of the review, which has been welcomed by the First Minister and received cross-party support in Parliament last Wednesday, said the report made it clear that it should be abolished.

Now, she said, the aim was to look at finding ways to stop its use. “I think part of the challenge is we know that use of restraint is not properly documented and recorded,” she added. “We are very clear we need to know when and where it’s happening and why. There is a lot of work to do so that we can stand-up very soon and say Scotland no longer uses restraint.

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“We’ve brought together people who are ready to look at ending restraint. But we also know that people who may not have wanted to be part of those conversations might be the people that are using it.”

The Care Review also noted that seclusion, “where children are contained and isolated often for long periods”, was not an “acceptable part of trauma-informed care”.

SallyAnn Kelly, the CEO of children’s charity Aberlour, welcomed the recommendation and said the organisation, which runs children’s homes for those with complex needs, was working hard to reduce incidences. It has halved its use over the last year to about three times a month and is committed to phasing it out.

In June 2019 Who Cares? Scotland called for the immediate end to physical restraint in all care settings as part of its We Don’t Have to Wait report. The charity – which claims its knows of six care-experienced people dying in December 2019 alone – says the next steps are “literally a matter of life and death” and must be taken urgently to safeguard those in care.